Attachment 04 Quality Assurance Surveillance Plan.pdf

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STANDARD LABOR DATA COLLECTION AND DISTRIBUTION APPLICATION (SLDCADA) DRAFT REQUEST FOR PROPOSAL
Solicitation number
N0003926R0005
Issued by
Not on record

About this file

This is a Quality Assurance Surveillance Plan (QASP) for the Standard Labor Data Collection and Distribution Application (SLDCADA) task order under PMW 220 Navy ERP Financial IT Solutions, dated 9 October 2026. The QASP establishes the Government's systematic methods for measuring and monitoring contractor performance in delivering end-to-end integrated system sustainment and infrastructure support services for SLDCADA, an unclassified, web-based time and attendance and labor reporting system supporting more than 60,000 users. The document is classified as CUI (Controlled Unclassified Information) with restricted distribution limited to PMW 220 or higher authority.

The contractor must deliver services across six principal focus areas: Program Management; Release Management (two planned semi-annual releases with zero Priority 1 defects knowingly released); IT System Management and Support (maintaining system reliability and availability metrics within PWS parameters); Data and Interface Management Support (ensuring data quality, integrity, and security); Customer Support (Help Desk response within two hours during core hours with at least 90 percent ticket closure within priority standards); and Project-Specific Work including cloud migration and RMF/ATO support. Performance is monitored through multiple methods including 100 percent CDRL inspection, partial inspection, random sampling, analysis of metrics and logs, and performance review meetings. The Government will issue Performance Assessment Reports (PARs) for minor deficiencies (five business day response), Corrective Action Reports (CARs) for significant or systemic deficiencies, and Customer Complaint Records (CCRs) for validated complaints. Annual formal performance evaluations will assign CPARS ratings of Exceptional, Very Good, Satisfactory, Marginal, or Unsatisfactory based on performance objectives across cost, schedule, quality, business relations, and key personnel management. The contractor is responsible for internal quality controls through its Quality Assurance Plan and Quality Management System; this Government QASP establishes external surveillance standards and does not duplicate contractor responsibilities.

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CUI

Quality Assurance Surveillance Plan (QASP)

Standard Labor Data Collection and Distribution Application

(SLDCADA)

Date: 9 October 2026

Distribution Statement F: Further dissemination only as directed by PMW 220 (8 September 2026) or higher authority. Refer requests for this document to the SLDCADA Program Office.

Destruction Notice: Comply with the distribution statement and destroy by any method that will prevent disclosure of contents or reconstruction of the document.

Quality Assurance Surveillance Plan

(QASP)

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Table of Contents

1 PURPOSE

2 TASK ORDER EFFORT

3 WORK REQUIREMENTS SUMMARY

4 ROLES AND RESPONSIBILITIES

4.1 GOVERNMENT PROGRAM LEAD / ASSISTANT PROGRAM MANAGER (APM)

4.2 PROCURING CONTRACTING OFFICER (PCO)

4.3 CONTRACTING OFFICER’S REPRESENTATIVE (COR)

5 METHODS OF SURVEILLANCE

5.1 CONTRACT DELIVERABLE (CDRL) INSPECTION

6 SURVEILLANCE FOCUS AREAS

7 PERFORMANCE OBJECTIVES AND COMPLIANCE

8 EVALUATION AREAS

9 PERFORMANCE RATINGS

10 EVALUATION PERIODS / TIMELINE

APPENDIX A: PERFORMANCE ASSESSMENT REPORT (PAR)

APPENDIX B: CORRECTIVE ACTION REPORT (CAR)

APPENDIX C: CUSTOMER COMPLAINT RECORD (CCR)

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1 PURPOSE

This Quality Assurance Surveillance Plan (QASP) is a Government-developed and applied document that describes the systematic quality assurance methods and guidelines used by the Procuring Contracting

Officer (PCO), Contracting Officer’s Representative (COR), and SLDCADA Government program leadership to measure and monitor contractor performance.

This surveillance plan is developed in accordance with the applicable inspection and quality assurance clauses of the Federal Acquisition Regulation (FAR), including FAR Part 46, Quality Assurance.

Government acceptance of supplies and services will be performed by the Contracting Officer or an authorized representative acting within the authority delegated in writing.

Specifically, this QASP provides the performance criteria, standards, surveillance methods, and procedures the Government will use to assess whether contractor services are timely, effective, secure, accurate, and compliant with the results required by the SLDCADA Performance Work Statement (PWS).

The contractor, not the Government, is responsible for management and quality control actions necessary to meet the quality standards set forth by the contract. The contractor’s Quality Assurance Plan and Quality

Management System are required to establish the contractor’s internal quality controls; this Government

QASP does not duplicate those responsibilities.

This QASP is a living Government surveillance document. Surveillance frequency and intensity may be increased or decreased based on contractor performance, risk, mission impact, and the results of prior surveillance.

In the event of any conflict among this QASP, the PWS, CDRLs/DD Form 1423s, and the contract/task order, the contract/task order and direction of the Contracting Officer govern.

2 TASK ORDER EFFORT

Work performed under this task order supports the Standard Labor Data Collection and Distribution

Application (SLDCADA). SLDCADA is an unclassified, web-based, customizable time and attendance and labor reporting system. The PWS objective is to provide end-to-end integrated system sustainment and infrastructure support services for SLDCADA.

The SLDCADA solution includes production, development, testing, high-availability, and disaster-recovery environments and supports more than 60,000 users. Contractor services include program management, software engineering and release management, IT infrastructure and cybersecurity, configuration management, Full Financial Statement Audit (FFSA), including IT General Controls support, data and interface management, customer support, training, and additional project-specific services.

3 WORK REQUIREMENTS SUMMARY

For a complete description of the scope and requirements of this task order, see the SLDCADA PWS and applicable CDRLs.

The scope of SLDCADA services is organized into Sustainment Support Activities Program of Record

(POR) requirements and Additional Services. The principal sustainment task areas are:

• Program Management

• Release Management

• IT System Management and Support

• Data and Interface Management Support

• Customer Support

Additional Services include cloud/alternate data center migration, new user community implementations, Risk Management Framework/Authority to Operate support, FFSA and specifically authorized completion

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efforts such as integration with Naval Identity Services (NIS) implementation and Government equipment disposal.

4 ROLES AND RESPONSIBILITIES

4.1 GOVERNMENT PROGRAM LEAD / ASSISTANT PROGRAM MANAGER (APM)

The Government Program Lead/APM provides primary program oversight and monitors contractor performance against program objectives. The Program Lead/APM may provide Government technical guidance and feedback within the scope of the contract, but is not authorized to make contractual commitments or changes unless separately warranted as a Contracting Officer. The Program Lead/APM supports the COR and PCO in performance assessment, prioritization, risk management, and program reviews.

4.2 PROCURING CONTRACTING OFFICER (PCO)

NAVWAR will assign a duly appointed PCO with authority to enter into, administer, modify, and terminate contract actions and to make related determinations and findings on behalf of the Government.

Only the Contracting Officer may change contract terms, conditions, price, schedule, or scope.

4.3 CONTRACTING OFFICER’S REPRESENTATIVE (COR)

The COR is responsible for continuous technical surveillance of contractor performance within the authority delegated by the PCO. The COR is not authorized to make contractual commitments or changes.

The COR will notify the PCO of performance issues or potential changes that may affect price, scope, schedule, terms, or conditions of the contract. The PCO delegation memorandum is the source of authority for the COR.

5 METHODS OF SURVEILLANCE

Requirements for performance include CDRLs, other work products, system and operational metrics, automated logs, support-ticket data, test results, financial information, status meetings, and evidence of successful performance of the PWS. The COR will monitor performance and review contractor-furnished reports and objective evidence to determine whether performance meets documented requirements and

Acceptable Quality Levels (AQLs).

The Government will provide timely written feedback regarding unacceptable performance so the contractor can identify root causes and implement corrective action. The Government may use any combination of the following surveillance methods:

• 100% Inspection - evaluation of all designated tasks, deliverables, or transactions when mission impact or practicality warrants full inspection.

• Partial Inspection - selective review of less than 100% of designated tasks when full inspection is not required or practical.

• Random Sampling - statistically or judgmentally selected review of a subset of recurring work or transactions.

• Analysis - examination of system metrics, automated tools, logs, dashboards, test evidence, survey results, ticket data, security reports, financial reports, and trends.

• Performance Review Meetings - review of contract performance during monthly In-Process Reviews

(IPRs), weekly status meetings, risk reviews, release readiness reviews, and other Government-directed reviews.

The PWS and this QASP will form the basis for COR surveillance checklists. The Government may also use Combatting Trafficking in Persons surveillance and any other compliance checks required by the contract.

Three forms may be used to document nonconformance and customer feedback:

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1. Performance Assessment Report (PAR) - used to document minor discrepancies and Government performance observations. Unless otherwise directed, the contractor should respond to a deficiency within five (5) business days.

2. Corrective Action Report (CAR) - used for significant deficiencies (including deficiencies impacting our FISCAM IT General Control auditability posture), repeated deficiencies, or systemic problems. The

COR will coordinate CAR issuance and disposition with the PCO. Contractor corrective action must address root cause, correction, and prevention of recurrence.

3. Customer Complaint Record (CCR) - used to document and validate customer complaints or feedback.

Validated complaints demonstrating noncompliance may result in a PAR or CAR.

5.1 CONTRACT DELIVERABLE (CDRL) INSPECTION

Periodic Government review and assessment of deliverables will be accomplished in accordance with this

QASP, the PWS, and the applicable CDRLs. Unacceptable or incomplete deliverables may be returned to the contractor for correction and resubmission within the timeframe established by the contract or the

Government.

The COR will monitor monthly status reporting, financial and contract management reporting, invoices, plans, schedules, release and test artifacts, audit (FFSA)/cybersecurity reports, customer support metrics, and other CDRLs identified in PWS Appendix A. The COR will also monitor invoices and supporting documentation to ensure charges and performance align with authorized tasking and applicable CLINs.

Formal Contractor Performance Assessment Reporting System (CPARS) evaluations will be completed at least annually, at completion/closeout, or more frequently when determined appropriate by the

Government. The Government will evaluate quality, schedule, cost control when applicable, management, business relations, and other CPARS factors applicable to the effort.

6 SURVEILLANCE FOCUS AREAS

Table 1 identifies the principal SLDCADA surveillance focus areas. These focus areas combine the core sustainment workstreams with the performance measures and completion criteria that have the greatest impact on mission success.

Focus Area Overview Acceptable Quality Level Method of

Surveillance

PWS 6.1.1

Program

Management

Oversight and integration of the full scope of the task order, including planning, reporting and metrics, schedule, risk, configuration management, audit support, quality, communications, and transition.

Performance is timely and complete

IAW the PWS/CDRL schedule.

Monthly status and financial/contract reports are complete; IMS is maintained and updated as required; risks/issues and corrective actions are actively managed; required meetings, minutes, plans, and audit/compliance artifacts are delivered and current.

Partial inspection;

100% CDRL

inspection; review of

IMS, reports, risk/CM/audit evidence; IPRs and status meetings.

PWS 6.1.2

Release

Management

Planning, software engineering, testing, deployment, documentation, and assessment of semi-annual capability releases and interim patches.

Two planned releases are managed

IAW the approved schedule. No

Priority 1 defect is knowingly released. Priority 1 defects are resolved within 8 hours; Priority 2 before the end of the next pay period; Priority 3 within 30 business

100% review of release CDRLs/test evidence; defect and release-quality metric analysis; User

Acceptance/Beta survey review;

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Focus Area Overview Acceptable Quality Level Method of

Surveillance days; Priority 4 in the next or following release as allowed by the

PWS. User Acceptance satisfaction averages >=4/5 or >=80%, or an approved corrective action plan is provided.

readiness and release reviews.

PWS 6.1.3

IT System

Management and Support

Operation, maintenance, cybersecurity, system performance, availability, cloud environment support, account management, contingency/COOP, and batch operations.

System RAM/operability metrics remain within PWS parameters and deviations are reported/analyzed.

Weekly batch processing achieves at least 98% error-free execution.

Unexpected RAM/operability deviations are reported within one business day of discovery;

unplanned system/network issues are reported as soon as possible and no later than four business hours after discovery. Required production support, cyber, account management, and contingency plans are current.

Analysis of monthly/weekly metrics, system logs, incidents and root-cause reports; 100%

CDRL inspection;

cybersecurity/ATO evidence;

performance reviews.

PWS 6.1.4

Data and

Interface

Management

Support

Data quality, integrity, governance, reconciliation, interfaces, API development, trading partner coordination, security of PII, and interface monitoring.

Data and interface services are complete, accurate, secure, traceable, and timely IAW approved plans and interface requirements.

Data reconciliation, validation, error resolution, root-cause analysis, trend reporting, and required interface documentation are maintained.

Analysis of data/interface logs, reconciliations, incident records, test results, agreements, and CDRLs; partial or 100% inspection based on risk.

PWS 6.1.5

Customer

Support

Help Desk, customer operations, training, pay-period support, customer satisfaction, and user communications.

Help Desk responds within two hours during core hours; Priority 1 tickets receive off-hours response within two hours. At least 90% of tickets are closed within the applicable priority standard and repeat tickets do not exceed 10% within a two-week period. Training and annual customer satisfaction average at least 80%, or corrective action is provided. Required twice-monthly training and surveys are performed.

Analysis of Help

Desk metrics, ticket samples, trend reports, customer/training surveys, customer complaints, and

100% review of required CDRLs.

PWS 6.2 and

Appendices

D/E

Project-specific work such as cloud migration, new user implementations, Authorized work remains within scope, funded/labor ceilings, approved project plans, and

100% inspection of completion criteria, project schedules, PMW 220 Navy ERP Finanical IT Solutions

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Focus Area Overview Acceptable Quality Level Method of

Surveillance

Additional

Services /

Completion

Efforts

RMF/ATO support, FFSA support, NIS Completion

CLIN 2220, and

Government equipment disposal Completion CLIN

2230 when authorized.

completion criteria. Required milestones and deliverables are completed, submitted, and accepted before the Government determines the completion effort is complete.

deliverables, invoices/cost data as applicable, and

Government acceptance evidence.

7 PERFORMANCE OBJECTIVES AND COMPLIANCE

The performance objectives identified in Table 1 and the PWS will be monitored on an ongoing basis. The contractor is responsible for measuring its own performance and reporting required metrics and trend analysis in the Monthly Status Report, Financial and Contract Management Report, Quality Assurance Plan reporting, and other CDRLs.

All work performed under the task order shall comply with the Federal, Department of Defense, Department of the Navy, NAVWAR, cybersecurity, audit, records management, accessibility, data, privacy, and other directives identified in the PWS and contract. The PCO will communicate approved changes to applicable requirements when contractually necessary.

All work shall comply with security and audit requirements established by the contract, DD Form 254, PWS security and audit provisions, CUI requirements, and applicable cybersecurity workforce requirements. The contractor is responsible for ensuring required training, certifications, access controls, personnel security, and reporting are current.

Unless exempted by the contract, information and communications technology developed or maintained under this effort shall comply with Section 508 accessibility requirements.

8 EVALUATION AREAS

Table 2 provides the principal contract-level evaluation standards, performance objectives, performance standards, AQLs, monitoring methods, and associated performance outcome. The table is aligned to the

PWS Appendix B Contract Performance Based Matrix and applies only where the underlying contract requirement is applicable.

Standard Performance

Objective

Performance

Standard

Acceptable

Quality

Level (AQL)

Monitoring

Method

Incentive

1. Cost (a) Demonstrate cost control for non-firm-fixed-price work; explain cost deviations.

(b) Submit timely, accurate, complete invoices.

(a) Monthly reporting addresses cost deviations.

(b) Invoices comply with contract terms.

(a) Cost deviation details delivered with monthly reporting

92% of the time;

deviations justified to

Government satisfaction

100% of the time.

100% review of applicable monthly cost reports and invoices.

Positive/negativ e performance evaluation

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Standard Performance

Objective

Performance

Standard

Acceptable

Quality

Level (AQL)

Monitoring

Method

Incentive

(b) 92% of invoices timely, accurate, complete, and free of rework.

2. Schedule (a) Demonstrate schedule control and project progress.

(b) Submit deliverables/CDRL s by required due dates.

(a) Progress demonstrated.

(b) On-time delivery.

(a) Monthly reports clearly demonstrate project progress 92% of the time.

(b) 95% of contract deliverables submitted in accordance with the contract/task order schedule.

100% review of monthly progress reports and deliverable receipt dates against due dates.

Positive/negativ e performance evaluation

3. Quality (a)

Deliverables/CDRL s comply with contract requirements and are of acceptable quality.

(b) Monthly progress reporting addresses significant performance issues.

(a) Deliverables rated Satisfactory.

(b) Significant issues addressed.

(a) Average deliverable rating is

Satisfactory, with no more than two final

Unsatisfactor y deliverable ratings per year.

(b) Monthly reports address performance issues 100% of the time.

100% review/rating of deliverables and progress reports.

Positive/negativ e performance evaluation

4. Business

Relations

(a) Responsive to

Government communications on cost, schedule, and performance.

(a) Respond within two business days.

(b) Report identified fraud vulnerabilities/activ

(a) Respond to requests within two business days

95% of the

Tracking/loggin g of

Government requests and contractor

Positive/negativ e performance evaluation

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Standard Performance

Objective

Performance

Standard

Acceptable

Quality

Level (AQL)

Monitoring

Method

Incentive

(b) Advise

Government of vulnerability to fraud or active fraud and comply with applicable business ethics requirements.

e fraud within 15 business days, as applicable.

time.

(b) Required fraud reporting is made 100% of the time within 15 business days of identification.

responses;

review of applicable fraud reports.

5. Key

Personnel

Managemen t

(a) Notify

Government when

Key Personnel replacement is required.

(b) Provide qualified replacements.

(c) Meet replacement timelines.

(d) Notify

Government of labor disputes that may affect performance.

Notifications and replacements comply with contract requirements and approved timelines.

KP

replacement notifications within 15 business days

100% of the time;

replacement resumes within required timelines;

replacements meet qualifications

; labor disputes reported within seven business days

100% of the time.

Review of KP notifications, resumes, replacement dates, and labor dispute notices.

Positive/negativ e performance evaluation

9 PERFORMANCE RATINGS

The Government will evaluate contractor performance and the Assessing Official will assign CPARS ratings, as applicable, using the following standard categories: Exceptional, Very Good, Satisfactory, Marginal, and Unsatisfactory.

Rating Definition Note

Exceptional Performance meets contractual requirements and exceeds many requirements to the

Government’s benefit. Performance is accomplished with few minor problems and corrective actions are highly effective.

Identify significant events and measurable

Government benefit. There should be no significant weaknesses.

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Rating Definition Note

Very Good Performance meets contractual requirements and exceeds some requirements to the

Government’s benefit. Minor problems are effectively corrected.

Identify at least one significant event and its benefit to the Government. There should be no significant weaknesses.

Satisfactory Performance meets contractual requirements.

Minor problems may occur, but corrective actions are satisfactory and any major problems are recovered without material impact.

Contractors are not rated below

Satisfactory solely for not exceeding requirements. Significant weaknesses should not remain uncorrected.

Marginal Performance does not meet some contractual requirements. A serious problem exists and corrective actions are not yet fully effective or implemented.

Identify significant events, their impact, and the management tool used to notify the contractor of the deficiency.

Unsatisfactory Performance does not meet most contractual requirements and recovery is not likely in a timely manner. Serious problems exist and corrective actions are ineffective or absent.

Identify significant events and Government impact. An Unsatisfactory rating should be supported by documented contract surveillance and deficiency notices.

NOTE 1: Plus or minus indicators may be used internally to show an improving or worsening trend that is insufficient to change the formal evaluation status.

NOTE 2: N/A may be used when a rating factor is not applicable to a particular period or CLIN.

10 EVALUATION PERIODS / TIMELINE

The contractor’s overall performance will be evaluated by the Government at least annually and at final contract/task order completion. Interim or informal evaluations may be performed at Government-directed reviews or whenever performance risk warrants increased surveillance.

Evaluations will encompass all applicable work performed during the assessment period, including sustainment, additional services, and authorized FFP, CPFF, or completion CLINs. Prior-period information may be considered when it is relevant to unresolved corrective actions or recurring performance trends.

The Assessing Official will make a performance determination based on COR surveillance, Government program input, contractor comments, objective performance data, and other information deemed relevant by the PCO. Formal CPARS processing will follow applicable CPARS procedures and contract requirements.

Task Area Assessment

Period

Performance

Standards

AQL Method of

Surveillance

Outcome

All applicable tasks

Each annual assessment period

See Sections 6-8 and applicable

PWS/CLIN

requirements.

Performance rated at least

Satisfactory and mission-critical

AQLs met or effectively corrected.

Periodic and event-driven inspection of contractor performance, metrics, deliverables, and corrective actions.

Supports annual

CPARS and

Government decisions regarding continued performance/options, as applicable.

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Task Area Assessment

Period

Performance

Standards

AQL Method of

Surveillance

Outcome

Completion

CLIN /

Additional

Service

At completion of the authorized effort

Approved project plan, completion criteria, deliverables, cost/funding controls, and applicable PWS requirements.

All completion criteria satisfied and required deliverables accepted by the

Government.

100% inspection of completion evidence, deliverables, schedule, and applicable cost data.

Government determination of completion/acceptance and closeout.

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APPENDIX A: PERFORMANCE ASSESSMENT REPORT (PAR)

PAR Instructions

Block 1. Quality Assurance Personnel (QAP) enters contract/task order number.

Block 2. QAP enters contractor name.

Block 3. QAP enters type of services.

Block 4. QAP signs and dates.

Block 5. QAP enters telephone number.

Block 6. QAP assigns suspense date for Contractor Representative validation if a deficiency is identified.

Part I - Contractor Performance. QAP identifies the PWS/service item reviewed, documents the deficiency

(if any), and records the detailed performance assessment.

Part II - Contractor Validation. Contractor Representative concurs or non-concurs and documents corrective action, estimated completion, root cause, and prevention of recurrence.

Part III - Deficiency Corrected. QAP documents acceptance/non-acceptance of corrective action and closure remarks.

PERFORMANCE ASSESSMENT REPORT (PAR)

1. CONTRACT/TASK ORDER

NUMBER

2. CONTRACTOR 3. TYPE OF SERVICES

4. QUALITY ASSURANCE PERSONNEL SIGNATURE AND

DATE

5. QAP PHONE / 6. SUSPENSE

DATE

I. PERFORMANCE

7. DEFICIENCY: [ ] NEW [ ] REPEAT [ ] NO DEFICIENCY NOTED

8. SERVICES SUMMARY /

PWS PARAGRAPH ITEM

REVIEWED

9. BRIEF DESCRIPTION OF DEFICIENCY

10. DETAILED PERFORMANCE ASSESSMENT

II. CONTRACTOR VALIDATION

11. CONTRACTOR REPRESENTATIVE: [ ] CONCUR [ ] NON-CONCUR 12. CORRECTIVE

ACTION ESTIMATED COMPLETION DATE

13. CONTRACTOR CORRECTIVE ACTION, ROOT CAUSE, AND PREVENTION OF

RECURRENCE / REASON FOR NON-CONCURRENCE

III. ACTION CORRECTED

14. [ ] CONCUR [ ] NON-CONCUR QAP SIGNATURE/DATE

15. QAP REMARKS (REQUIRED)

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16. CONTRACTOR REPRESENTATIVE REMARKS

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APPENDIX B: CORRECTIVE ACTION REPORT (CAR)

CAR Instructions

Block 1. Enter Contractor Name. Block 2. Enter Contract/Task Order Number. Block 3. Enter Contract

Name or Type of Services.

Block 4. Enter Functional Area. Block 5. Enter the contractor response suspense date. Block 6. Enter the

CAR control number.

Block 7. Identify the deficiency as Major or Minor, state the finding, cite the contractual requirement, and describe mission or performance impact.

Blocks 8 and 9. Quality Assurance Personnel and the Issuing Authority sign and date the CAR.

Block 10. QAP documents acceptance/rejection of the contractor corrective action and follow-up surveillance.

Blocks 11 and 12. QAP records the determination and close date.

CORRECTIVE ACTION REPORT (CAR)

1. CONTRACTOR 2. CONTRACT/TASK ORDER

NUMBER

3. TYPE OF SERVICES

4. FUNCTIONAL AREA 5. SUSPENSE DATE 6. CONTROL NUMBER

7. DEFICIENCY: [ ] MAJOR [ ] MINOR

FINDING:

FINDING IMPACT:

8. QUALITY ASSURANCE PERSONNEL - NAME / SIGNATURE

/ DATE

9. ISSUING AUTHORITY -

NAME / SIGNATURE / DATE

10. QAP RESPONSE TO CONTRACTOR CORRECTIVE ACTION AND PREVENTION OF

RECURRENCE

11. QAP DETERMINATION: [ ] ACCEPTED [ ] REJECTED 12. CLOSE DATE

CONTINUATION / FOLLOW-UP SURVEILLANCE NOTES

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APPENDIX C: CUSTOMER COMPLAINT RECORD (CCR)

CUSTOMER COMPLAINT RECORD

DATE/TIME OF COMPLAINT

SOURCE OF COMPLAINT

ORGANIZATION / INDIVIDUAL / PHONE

CONTRACT REFERENCE

NATURE OF COMPLAINT

VALIDATION

DATE/TIME CONTRACTOR INFORMED OF COMPLAINT

ACTION TAKEN BY CONTRACTOR

RECEIVED / VALIDATED BY

End of Quality Assurance Surveillance Plan

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